Functionality of the support to the family of children with pneumonia. / Funcionalidade do apoio à família da criança com pneumonia.

OBJECTIVE: To know the composition and functioning of the social support used by the family of children with pneumonia. METHODS: A qualitative study was carried out with fourteen families of children under five years old hospitalized for pneumonia, coming from regions of greater social vulnerability in a city in the state of São Paulo, from November 2015 to May 2016. The theoretical reference used was the Calgary Family Assessment Model, and the Bardin Thematic Content Analysis was used as method. RESULTS: The nuclear family and the extended family constitute the social support used; the support network accessed includes the Primary Health Care, Emergency Care Units and hospitals, observing intersectoral referral and counter-referral failure. FINAL CONSIDERATIONS: The family reorganization proved to be relevant and effective in times of crisis; the families seek the secondary level of health care to solve the illness of their child.

The social network and support of kidney transplantees. / A rede e apoio social do transplantado renal.

OBJECTIVE: to know the social network and support of those who experience the process of kidney disease and transplantation. METHODS: a descriptive qualitative study, based on the concept of social network and social support from Sherbourne and Stewart. Semi-structured interviews were conducted from November 2013 to September 2014, with 12 kidney transplantees, which passed through content analysis. This study had the following selection criteria: the interviewee must have had a transplant five years ago, at most, be at lease 16 years of age and have preserved cognitive and language skills. RESULTS: three categories were constructed from the analysis process that link the family as the main component of the social network, health service offers support in its various dimensions, even if it is occasionally disconnected; other interpersonal relationships are mentioned as vulnerable in this process; spirituality helps in coping. CONCLUSIONS: despite the different forms of support for transplantees, weaknesses were observed in these networks and social supports.

[Experience of family members providing care for HIV-exposed children: beginning of the trajectory]. / Experiência de familiares no cuidado à criança exposta ao HIV: o início da trajetória.

During and after pregnancy, mothers with HIV can undergo treatment that is capable of preventing vertical transmission (VT) to their babies. The purpose of this study was to analyze the experience of family members that provide care for children whose mothers have HIV, to reduce the risk ofVT, with emphasis on the beginning of this trajectory. This study was based on the qualitative approach and Symbolic Interactionism was adopted as a theoretical framework. A total of 36 family members participated in the study, all of whom were carers of children aged up to 18 months and waiting for confirmation of the HIV diagnosis. Data were collected in a hospital in north-eastern Brazil, between December 2012 and February 2013, and examined by means of content analysis. Child care began during pregnancy, when the possibility of the child having HIV was expected. Some had previous experience in providing care for exposed children. Understanding the early trajectory of care will help find ways to provide better support for carers during the trajectory of diagnosis confirmation.

[Children's chronic disease:family needs and their relationship with the family health strategy]. / Doença crônica da criança: necessidades familiares e a relação com a estratégia saúde da família.

The purpose of this study was to learn the perception that families of children with a chronic disease make of their relationships with the Family Health Unit (FHU). This qualitative study was performed using symbolic interactionism as the theoretical ground and narrative inquiry as the method. Data were collected through semi-structured interviews with seven families of children with chronic disease, enrolled in the FHU of a region with high social vulnerability, in Sdo Paulo state, Brazil. Results showed that the family's relationship with the FHU is influenced by elements from their experience and trajectory, and that their experience as a family of a child with a chronic disease is strongly marked by their relationship with the health care services. This has great influence on the responses of the family, thus requiring a systematic and committed engagement of the health system in relieving their suffering, beyond merely treating the disease.

[Continued care for families of children with chronic diseases: perceptions of Family Health Program teams]. / Acompanhamento de famílias de crianças com doença crônica: percepção da equipe de Saúde da Família.

The objective of this study is to characterize how the Family Health Strategy teams in Brazil perceive their role to provide continued care to families of children with chronic diseases. This was a qualitative study that used symbolic interactionism as its theoretical framework, with content analysis for thematic categorical analysis. Focus groups with three Family Health Strategy teams were used for data collection, with a total of 32 study participants. The results were organized into three thematic categories: 1) singularities of families that live with children with chronic diseases; 2) team, family and Family Health Strategy; and 3) limitations of care . The teams' perception is that the design of the Family Health Strategy encourages access to the family experience, allowing the recognition of its specificities. Further, the data reveal team limitations regarding their capacity to provide care, and the need for investments in articulation with different social services, sectors, and equipment.

[The perceptions of families with children having chronic diseases and their relationships with healthcare professionals]. / Percepções da família da criança com doença crônica frente às relações com profissionais da saúde.

The prevalence of chronic disease in childhood has increased, placing families in constant contact with health professionals. In such situations the relationship with health professionals has an important role. Few scientific studies address this theme, in spite of its being highlighted as fundamental for effective interaction. The aim of this study was to characterize how the family of a child with a chronic disease perceives its relationship with health professionals. Twenty caregivers for children with chronic diseases were interviewed. The theoretical and methodological frameworks were, respectively, symbolic interactionism and thematic content analysis. The analytical process revealed four themes: role of the caregiver, stressful relationships, services and professionals, and seeking welcoming relationships. The outcomes of this interactional process, which show an incongruity of expectations and behaviors between professionals and families, are poor and generate feelings of abandonment. These can be eased through listening and understanding by other families in similar situations.

[Evaluation of the attitudes of children living with seniors toward aging]. / Avaliação da atitude de crianças que convivem com idosos em relação à velhice.

With the aging of the population, it is important to identify how other age groups perceive the elderly. The objective of this quantitative, cross-sectional and descriptive study was to evaluate the attitude of children living with seniors toward aging. Interviews were conducted with 54 children, aged between seven and ten years old, living with elderly people. After sociodemographic data were collected, the Todaro Scale for the Assessment of Attitudes of Children Toward the Elderly was applied. It assesses the domains of persona, cognition, social interaction, and agency. Most children were nine years old, male and had lived with an elderly individual for at least five years. The results showed positive attitudes. The persona domain was associated with 'time living with a senior.' This study's results support health professionals in planning educational interventions, designed to maintain and improve the attitudes of children toward the elderly.

[The construction of a Project in adolescent maternity: an experience report]. / A construção de um projeto na maternidade adolescente: relato de experiência.

This article reports on the experience of a group of nursing faculty on the development of a project aimed at adolescent maternity with a view to prevent unwanted pregnancies. An additional proposal of the referred project is guiding adolescent mothers in terms of self-care, care with their babies, and encouraging exclusive breastfeeding. This would reduce the difficulties that those young mothers experience and, therefore, contribute with the maternal-child area.

[Type 1 diabetes mellitus: evidence from the literature for appropriate management in children's perspective]. / Diabetes mellitus tipo 1: evidências da literatura para seu manejo adequado, na perspectiva de crianças.

The objective of this study was to identify the evidence available in the literature that address, for children's perspective, factors that are relevant for an appropriate management of type 1 diabetes mellitus. An integrative review was performed on the PubMed, CINAHL, LILACS, CUIDEN and PsycINFO databases, covering the period from 1998 to 2008 and using the following keywords: type 1 diabetes mellitus, child, prevention and control, triggering factors, emergencies, self care, learning and health education. Nineteen of the surveyed articles were selected, and their analysis revealed the following categories: living with diabetes; self care and glucose profile; the actions of family, friends and health professionals; and school. The evidence show that children appreciate the support they receive from their relatives, which have a direct relationship with being prepared for self care. Other members apart from their network are also valued. Areas that deserve attention are the school, the personal experience of each child, and health education.

Seeking tirelessly for better health and life conditions for the child with myelomeningocele.

OBJECTIVE: to understand the experience of families in the care of children with myelomeningocele. METHOD: a qualitative research study, which adopted Symbolic Interactionism and Grounded Theory as its theoretical and methodological framework, and the semi-structured interview as a data collection instrument. Twenty-eight participants from thirteen families living in a municipality in the inland of São Paulo took part in the study. RESULTS: the family tirelessly seeks better health and life conditions for the child with myelomeningocele; aiming at the child's autonomy, it is mobilized to the necessary treatments, to learn the care, to adapt the routine, as well as to supply for all the child's needs so that it reaches potential development, looking for a less dependent future with inclusion and social ascension. CONCLUSION: family nursing shows potential support in the face of myelomeningocele, due to its ability to apprehend the family system, evaluate it and enable intervention proposals in the care process. In this study, rehabilitation nursing was also emphasized, since it goes together with the child and the family who experience myelomeningocele.

[Social support to the family of the cancer patient: identifying ways and directions]. / Apoio social à família do paciente com câncer: identificando caminhos e direções.

Network and social support are resources that nursing can offer to families. This review identifies which aspects of social support are being investigated for the family of the cancer patient. Fifty one articles were found of which 70% were quantitative research and 26% were published in the last two years. The issues addressed were: Family caregivers as provider of social support; Factors that interfere with social support; Religiosity as social support as well as support coming from educative programs, group activity and technological resources. Of these papers, 49% were written by nurses, with international emphasis on needs assessment, family experiences and support offered, while national articles emphasize definition concepts and identifying family needs focusing on intervention planning.

Patient safety: perception of family members of hospitalized children.

OBJECTIVES: to know the meaning attributed by family members to the health safety of pediatric patients, with attention to the possibilities of their collaboration. METHODS: this qualitative study was conducted with eighteen family members of children hospitalized in a pediatric unit, from January to July 2018. Symbolic Interactionism was used as a theoretical framework, and Inductive Content Analysis as method. RESULTS: child hospitalization poses risks to possible incidents and adverse events. Participants and professionals are responsible for patient safety. Thus, their actions focus on error prevention. Therefore, they seek information and observe in a vigil way professional care in classic aspects of safety. They conceive essential and favoring safety the approach centered on children and family members. Final Considerations: family members recognized the chances of errors and care damage, identified themselves as support in minimizing damage and were in partnership with the professional, increasing chances of effecting safety.

Suffering eases over time: the experience of families in the care of children with congenital anomalies.

This study aimed to understand the experience of caring for a child with a congenital anomaly from the family's perspective. Symbolic Interactionism and Grounded Theory were the theoretical and methodological references, respectively. Data collection was carried out with eight families with children having congenital anomalies through semi-structured interviews and participating observation. Data analysis reached axial coding. Results revealed two phenomena in the experience of families in delivering care to children with congenital anomalies--facing an initially difficult experience and suffering eases over time. We concluded that the understanding of this experience supports the need to reconsider the nursing care provided to families in the care of children with congenital anomalies.

School experience of the child and adolescent with visual impairment: family experience.

OBJECTIVE: to understand the experience of families about school experiences of children and adolescents with visual impairment. METHOD: a qualitative study developed through the Symbolic Interactionism and narrative research. Data were collected through a semi-structured recorded interview, with eleven families of children/adolescents with visual impairment, totaling 40 participants. RESULTS: two phenomena emerged: "exclusion context" and "impaired school performance". Prejudice experienced at school brings devastating consequences to the life of the visually impaired child/adolescent and his family. Isolation occurs, difficulty adapting to the support resource and deficits in school performance. FINAL CONSIDERATIONS: production contributes to awakening professionals involved with the assistance of these people. Effective participation of health professionals in this area is required to develop actions with students, teachers and families, aimed at meeting the needs of learning and health promotion, inclusion, and respect for differences.

Mothers living with HIV: replacing breastfeeding by infant formula.

OBJECTIVE: To explore factors that interact and shape the meaning and experience of mothers of HIV-exposed children in relation to replacing breastfeeding by infant formula. METHOD: A qualitative study was carried out with 23 mothers living with HIV, whose children were up to 18 months of age and under follow-up in a specialized care service. Symbolic Interactionism, semi-structured interviews and content analysis were adopted as theoretical framework. RESULTS: The social symbols of breastfeeding, the (un)availability of the milk formula and the (lack of)support of health professionals influenced the mothers' experience with formula feeding. Social, cultural and economic constraints have proved capable of undermining the conditions necessary for the replacement of breastfeeding. FINAL CONSIDERATIONS: The availability of infant formula, access to lactation inhibitor and quality of health services still represent challenges to eradicate new HIV infections in children.

Effects of cochlear implantation on adulthood. / Repercussões do implante coclear na vida adulta.

PURPOSE: To understand the benefits of cochlear implantation in adulthood under the perspective of users. METHODS: Qualitative study using Symbolic Interactionism and Straussian Grounded Theory as theoretical and methodological frameworks, respectively. The project was approved by the Research Ethics Committee of the aforementioned Institution (Opinion no. 482,019). Sixteen adult cochlear implant (CI) users aged 28-58 years participated in the study. The data collection instrument was a semi-structured interview with questions about changes caused by CI in the social relations, communication, family system, and personal, academic and professional spheres of life of users. RESULTS: The category Cochlear Implant Effects on Adulthood is part of a more comprehensive theoretical study that addresses how adult CI users cope with deafness. Together with its subcategories, it shows that CI intervenes in a revolutionary way in the lives of its users, because it increases their sense of security, enables them to see life from a new perspective, rescues self-confidence and self-esteem, enables them to communicate and interact more effectively, enjoy music and other entertainment, rescue old projects, and make plans for the future; thus assisting with the process of recovering independence in adult life. CONCLUSION: Subjective impressions of the users showed that cochlear implants not only improve their auditory performance, but also bring several positive changes to their social insertion and quality of life. Therefore, this intervention is highly beneficial to deaf adults.

OBJETIVO: Compreender os benefícios da implantação coclear na idade adulta sob a perspectiva dos usuários. MÉTODO: Pesquisa qualitativa, tendo o Interacionismo Simbólico e a Teoria Fundamentada nos Dados Straussiana como referencial teórico e metodológico, respectivamente. Projeto aprovado pelo Comitê de Ética em Pesquisa da instituição (Parecer n°482.019). Participaram do estudo 16 adultos usuários de implante coclear há pelo menos um ano, com idade entre 28 e 58 anos. O instrumento de coleta de dados foi a entrevista semiestruturada, que abrangeu questões inquirindo as mudanças causadas pelo implante coclear nas relações sociais, na comunicação, no sistema familiar e na vida pessoal, acadêmica e profissional do adulto. RESULTADOS: A categoria Repercussões do Implante Coclear na Vida Adulta faz parte de um estudo teórico fundamentado maior sobre o enfrentamento da surdez em adultos usuários de implante coclear. Junto às subcategorias que a compõem, ela evidencia que este dispositivo intervém de forma revolucionária na vida dos usuários, uma vez que ele aumenta a segurança, possibilita enxergar a vida sob uma nova perspectiva, resgata a autoconfiança e a autoestima, permite comunicar-se e interagir de modo mais eficaz, apreciar música e outros entretenimentos, retomar projetos e fazer planos para o futuro; ajudando, assim, no processo de resgate da independência da vida adulta. CONCLUSÃO: As impressões subjetivas dos usuários mostraram que o uso do implante coclear não apenas melhora o aproveitamento auditivo, mas traz também inúmeras mudanças positivas para sua inserção social e sua qualidade de vida. Portanto, esta intervenção mostra-se altamente benéfica para adultos com surdez.

Cochlear implant: the family's perspective.

OBJECTIVE: To understand the family's experience of a child who uses a cochlear implant (CI). Specifically, to identify the difficulties, changes, and feelings entailed by deafness and the use of the CI; the coping strategies; and to understand the role of the family for the child with a CI. METHOD: Qualitative research, using Symbolic Interactionism and Straussian Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semi-structured interview. A total of 9 families (32 individuals) participated in the study. The children's ages ranged from 6 to 11 years old (mean = 8.9 years old). RESULTS: Their experience is described in the following categories: Having to fight for results, Coping with difficult situations, Recognizing that you are not alone, Learning to overcome, and Having one's life restored by the implant. CONCLUSION: Cochlear implantation changes the direction of the child and the family's life by restoring the child's opportunity to hear and to obtain good results in her personal, social, and academic development. Even after implantation, the child continues to experience difficulties and requires the family's mobilization in order to be successful. The family is the principal actor in the process of the child's rehabilitation.

[Living with diabetes: the experience as it is told by children]. / Vivendo com o diabetes: a experiência contada pela criança.

Diabetes mellitus is a chronic disease that demands adaptation in the psychological, social and physical sphere. This study aimed to understand the experiences of children with the disease. Symbolic Interactionism and Grounded Theory were used as a theoretical and methodological reference framework, respectively. We interviewed children in the age group between 7 and 14 years old. A total of 7 topics were identified in the collected data, which were: "Experiencing something unexpected", "Facing a harsh reality", "Being afraid of what is happening", "Living under control", "Trying to adapt to a new reality", "Maturing with this close relationship" and "Seeing this disease from a different angle". Living with diabetes is something these children are confronted with daily from the very moment it is diagnosed, having to live with a restricted diet, insulin therapy and life style changes, facts that bring about feelings that range from fear to insecurity, to revolt, to acceptance and adaptation.

Support network for families of children and adolescents with visual impairment: strengths and weaknesses. / Rede de suporte da família da criança e adolescente com deficiência visual: potencialidades e fragilidades.

This study aimed to understand the interactions established between social support networks and families that have children and adolescents with visual impairment, in two different cities in the state of Sao Paulo, Brazil. This was a qualitative, descriptive study with symbolic interactionism as a theoretical framework. A genogram, ecomap and semi-structured interviews with 18 families were used. The method adopted for data analysis was narrative analysis. Two themes were found: potentials derived from the relationship with the support network, and, counterpoints in the support network. The family members accessed other members of their own family, friends, spiritual and cultural activities, health services, government institutions, and philanthropic organizations as support networks. The weakness in health services support is an obstacle to comprehensive healthcare for children and adolescents living in city A. In city B, other possibilities exist because it has a reference service. Despite the weaknesses in the support network in both cities, the family articulates and develops a foundation so that they can provide the best situation possible for their child or adolescent. It is up to health professionals to provide support to families and empower them to care for their members.

Technology-dependent children and the demand for pharmaceutical care. / Criança dependente de tecnologia e a demanda de cuidado medicamentoso.

OBJECTIVE: to understand the experience of mothers of technology-dependent children as regards pharmaceutical care. METHOD: this was a qualitative, descriptive-exploratory study developed based on open interviews using a structured characterization tool, and applied during home visits to 12 mothers caring for technology-dependent children. The data was submitted to inductive content analysis. RESULTS: this study is split into two themes: (i) maternal overload during pharmaceutical care, demonstrating the need to administer drugs continuously and the repercussions of this exhaustive care on the caregivers; (ii) the ease or difficulty of access to the medicines required, showing informal strategies and support networks. CONCLUSION: pharmaceutical care is a daily challenge expressed in maternal overload and difficulty accessing the drugs, made worse by failures in the care network and coordinated care.